I started taking birth control pills to help treat acne before age 20 and have yet to stop. I swallow those tablets each day with great speed. I’m so at ease that I forget to ponder what I’m ingesting.
Videos of men gawking at birth control information pamphlets on TikTok. Women sharing period horror stories on Instagram. There’s a section of social media dedicated to reproductive health. Influencers and brands push out information to help educate the public on their choices when it comes to contraceptives. But there’s a fine line between education and disinformation, and often, influencers can blur it.
Social Media, Medical Care, and Wellness Culture
Despite 40% of healthcare consumers using social media for medical information, there don’t seem to be any rules for medical professionals and users on social media platforms. Is access to plentiful information worth the risk of being misled, especially when it comes to reproductive health?
The wellness movement (and related influencers) often push followers to not take hormonal birth control. They cite powerful benefits, imagined harms, and positive transformations. With the USA’s current war on the right to abortion, navigating birth control options has never been more important. But, should potentially underqualified influencers have a stake in these discussions?
Pregnancy Prevention Is Not A New Practice
Felice Gersh, M.D. OB/GYN and founder/director of the Integrative Medical Group of Irvine and the author of Menopause: 50 Things You Need to Know said, “The earliest known forms of human birth control, other than withdrawal and abstinence, date back around 5,000 years ago to Egypt, Crete, and other ancient societies, where condoms were made from animal and fish intestines, bladders, and linen.”
“Around 4,000 years ago the Egyptians made a spermicide from crocodile dung and fermented dough,” she continued.
Christine E. Dehlendorf, a Medical Expert at Key Opinion Leaders, explained why birth control methods didn’t advance greatly before the nineteenth century. “Many of the early methods of birth control, like most premodern medicine, were founded not on science but on myth and magical thinking. Our knowledge of reproduction was rather restricted for most of human history since the mammalian fertilization process involving the sperm and egg wasn’t even seen until the late 19th century.”
Dehlendorf added, “With the creation of vulcanized rubber in 1839, colonial America experienced the first significant technical advancement in contraceptives.”
Modern contraceptives, or those developed in the last 150 years, include “modern condoms, diaphragms, spermicides, implantables, injections, IUDs, birth control pills, patches, and rings, as well as the development of various surgical treatments to sterilize men and women,” Gersh told Cashmere.
All About The Pill
One of the most popular – and criticized – methods of contraception in the modern era is the pill. According to the CDC, 14% of American women between 15-49 use it as their method of birth control.
But where did it come from? “With financial support from her affluent husband and her close friend Katharine McCormick, a world-renowned biologist and heir to a sizable fortune, Margaret Sanger launched the quest for the Pill in 1950. She also assisted two scientists, Gregory Goodwin Pincus, and John Rock, in their work,” Dehlendorf said.
But the means of creating oral contraception didn’t come without harm. Dr. Rock and Dr. Pincus tested the effectiveness of the pill on a sample group of 200 women in Puerto Rico. The doctors, free of the laws and regulations in the United States, failed to properly communicate the risks and provide informed consent to the participants. It’s almost Machiavellian in nature, but for the women who suffered and were robbed of their consent, does the end justify the means?
“The pill is a lot safer now than it was in the 20th century, with more variety to choose from,” Dehlendorf said. She added, “It has also had a big impact socially too. Over the past 85 years, women’s access to birth control has been their main source of economic growth. According to research, the birth control pill has directly contributed to one-third of the salary increases seen by women during the 1960s. The strongest motivator for allowing women to continue their college education once they have started is having access to the pill before reaching 21.”
Reproductive health has come a long way since the ancient days of fermented dough. Modern contraception empowers users to choose what to use, when, and for what. People can better design and take control of their lives.
Hormonal Birth Control Isn’t Risk-Free
While I hate to ally myself with influencers, hormonal birth control isn’t perfect. Like everything in this world, birth control comes with risks. “Birth control that contains estrogen can increase your risk of certain heart problems, such as heart attack, stroke, liver tumors, and blood clots, but these are very rare,” Dehlendorf explained.
Dangers differ for various types of contraception. For instance, “IUDs also carry associated risks, including perforation, pelvic infection, hormonal effects such as acne and depression, and alterations in the vaginal and local microbiomes,” Gersh added.
Gersh continued and offered a holistic perspective. “Birth control pills, when begun early and used for a long time may increase the lifetime risk of heart attack and stroke, may affect the brain in various ways, may lower optimal muscle and bone development, and may affect weight in some,” she said.
Health, History, Race, And Their Intersections
Beyond bodily side effects, it’s important to consider the societal impact of birth control. Issues like accessible healthcare, sex education, generational trauma, and more, impact the public perception of contraception.
This is well exemplified through the Black American community. This community has reason to distrust traditional medicine and doctors. First, the Black maternal mortality rate is 2.6 times higher than that of white women, regardless of income or education. Also, historical beliefs and institutional malpractices have demonstrated a large disregard for Black Americans’ health and dignity. Whether looking at the undertreatment of pain for Black Americans or the infamously unethical Tuskegee Syphilis Study, it is clear that Black individuals and families are fighting decades of fear and oppression when simply stepping into a doctor’s office.
Marriage and family therapist Dr. Janay Holland discussed the causes of the Black community’s fear of birth control. “We see generations of women that have been denied access to top providers due to race and financial barriers, but there’s also the idea that Black women have a different ‘pain tolerance’ than those of different races,” she said.
“This fear and mistrust of medical providers, especially in the area of birth control, causes the Black community to rely on less effective forms of birth control and/or prepare for unwanted pregnancies.”
Dr. Holland continued, “These unwanted pregnancies cause Black women to attend less doctor appointments, not adhere to doctors’ orders, or simply look to the internet for answers. This fear of having to find their own answers causes the Black community to have higher levels of anxiety and depression during pregnancy, as well as interrupting the family system because of additional financial strain or interruption of schedule,” Holland added.
The Influence of The Internet
Whether advertising products or advocating for lifestyle changes, social media influencers have power and influence on our lives. Navigating their aims, especially financial ones, alongside our health can be tricky.
Approximately 37% of consumers trust influencers more than brands. Also, Gen Z and Millennials — those currently at reproductive age — are twice as likely than Boomers to trust influencers. Even AdWeek has reported that Gen Z searches on TikTok rather than Google when looking for information.
Studies have shown that fitness influencers build brand credibility and promote a healthy lifestyle by pushing imaginary standards. Although this research does not comment on birth control, its focus on fitness accounts related to the overall wellness movement. Additionally, 33% of women continue to follow influencers on social media despite those accounts making them feel worse about themselves. Although some help to bring attention to important issues and help combat loneliness for their followers, influencers can promote poor health habits like undereating and increase followers’ risk for mental health conditions like body dysmorphia. Girl dinner, anyone?
A different research project found that eight out of nine influencers did not have the credibility to advise others on diet and nutrition and that their claims online were wrong. However, the one influencer deemed trustworthy by experts had the appropriate training and qualifications in their field, perhaps indicating the positive presence of accredited professionals online.
Misplaced Trust Can Be Dangerous
“The fear that I see is when people with no training are speaking on their opinions on birth control with no facts or evidence to back up their claim. These influencers are dangerous because it increases the fear in the community so patients will not even speak to their provider,” Holland commented.
“Generational trauma continues to intensify due to the increase of social media allowing the community to discuss and document the multiple instances of mistreatment that individuals of the Black community have faced in the medical community,” Holland added. Social media acts as a platform to bring awareness to evolving trauma and injustice.
However, Dehlendorf offered a silver lining: “There is a lot of great information online, and the more people that know about it will mean that we have less people suffering in silence because of stigma, or feeling like they have to keep their birth-control use a secret.”
Beyond influencers, anyone has the ability to share personal stories online. When people go to the internet for medical advice, they don’t know what they’re getting. It may be positive. They may be bombarded with patient stories of suffering extreme damage from birth control.
“Social media has also heightened the various cases where birth control has caused significant health issues for the Black community, and most of these cases have irreversible damage to the patient,” Holland added.
Without accessible and fair healthcare for all, we are left to our own devices, literally. We look to social media for answers, and fall responsible for mining the social field. Which accounts can be trusted? Who is telling the truth? What will happen to me if I follow the advice of someone I’ve never met?
Gersh added, “The problem is the lack of a simple-to-use, highly efficacious alternative to birth control pills.” With limited options and resources, one’s health can’t prosper.
Keep Disinformation Out Of Your Uterus
Making important medical decisions is hard enough, the influence of social media is the last thing we need.
“Take everything you read on the internet with a pinch of salt. While you might be able to find something that resonates with you, taking this information to a doctor for them to confirm is always the best thing,” Dehlendorf said.
It’s recommended to seek out evidence, multiple opinions, and trustworthy credentials. However, it’s most important to prioritize your wants and needs in reproductive healthcare. If you don’t want to pursue medical contraception, vocalize that.
“Every woman should always remember that her ovarian hormones are about the overall health of her body, including her brain, and not just about baby-making. It’s always best to have one’s own human hormones being produced and distributed throughout the body as much as possible while controlling for unwanted pregnancies and taking sexual relations seriously,” Gersh advised.
When we identify with medical practitioners, we may feel more validated and respected to receive the excellent care we deserve. “The Black community does seek medical opinions more often if they are able to find providers that are Black as well. Being able to see themselves in their providers allows for additional comfort and trust,” Holland added.
For those who encounter obstacles when obtaining treatment for their contraceptives, access to educational resources is critical. “Education needs to be spread about the use of contraception to those who use it or not so that everyone can make their own informed opinion,” Dehlendorf said. TikTok influencers shouldn’t always be the space to find those resources.
Try your best to differentiate the fake from the real on social media. Do your research. Find different resources and evidence to back up claims. Follow accounts with viable credentials.
Wellness culture should be about protecting yourself and furthering your health. That can only truly be achieved through accurate sex and reproductive education.